Sjöstrand J, Abrahamsson M
Department of Ophthalmology, Sahlgren's Hospital, University of Göteborg, Sweden.
Eye (Lond). 1990;4 ( Pt 6):787-93. doi: 10.1038/eye.1990.124.
Any intervention to prevent serious amblyopia is based on the knowledge about normal versus subnormal visual development. Our ability to predict with high degree of certainty which children will develop amblyopia will be dependent on the characteristics of various risk factors for initiating the development of squint or amblyopia. We have used longitudinal studies of population based cohorts of young children to define some of these risk factors such as refractive errors. Three hundred and ten children with an astigmatism greater than or equal to 1.0 D at one year of age were refracted yearly between the age one and four years. Astigmatism and anisometropia were found to be highly variable during infancy and early childhood. Longitudinal follow-up seems to be needed to separate the normal from the abnormal refraction development, which initiates the development of the amblyopia. Children with constant or increasing astigmatism or anisometropia between one and four years were 'at risk'. In parallel we have studied important factors for successful treatment of amblyopia. Based on these findings we conclude that a population screening at four years of age seems to be advantageous in Sweden in order detect and successfully treat most cases of amblyopia.
任何预防严重弱视的干预措施都基于对正常与异常视觉发育的了解。我们要高度准确地预测哪些儿童会患弱视，这取决于引发斜视或弱视发展的各种风险因素的特征。我们通过对以人群为基础的幼儿队列进行纵向研究，来确定其中一些风险因素，比如屈光不正。对310名一岁时散光大于或等于1.0 D的儿童在一岁至四岁期间每年进行验光。结果发现，散光和屈光参差在婴儿期和幼儿期变化很大。似乎需要进行纵向随访，以区分正常和异常的屈光发育情况，而异常的屈光发育会引发弱视。一岁至四岁期间散光或屈光参差持续存在或加重的儿童“有风险”。同时，我们研究了弱视成功治疗的重要因素。基于这些发现，我们得出结论，在瑞典，四岁时进行人群筛查似乎有利于发现并成功治疗大多数弱视病例。
